Volume 11 Issue 2 - 2017

The deed is done. Brexit is happening. We shall see what it brings to the NHS, a worsening of frontline medical and non-medical staff by all accounts. A trickle of exits of EU citizens may turn to a deluge if the issue of retaining citizenship is not resolved, early on in the negotiations. The worry is that the UK government may be relying on recruiting from outside the EU, such traditional heartlands as India, Nigeria and other Commonwealth of Nations. I am not sure if this will be easy as the laws on immigration and rights have so parred the advantages that there is unlikely to be a rush of healthcare staff wishing to come to the UK. The double whammy for politicians is that increasing numbers of staff, particularly in primary care, are choosing to retire early, work part time or simply have a career change. Plugging this gap, with the decision for additional places in medical school, will take over a decade for the effect to show. Indeed, the last round of undergraduate medical school places were unfilled and had to be offered in clearing. I cannot remember this happening in my working lifetime, 39 years. Jam tomorrow then!

Colorectal cancer is the third most common cancer in men and the second most common cancer in women worldwide. Incidence strongly increases with age, with the median age at diagnosis being 70 years in developed regions. Although 5-year relative survival exceeds 90% in stage I disease, it only marginally exceeds 10% in stage IV disease. This review aims to guide generalists through the early diagnosis, referral, and treatment of colorectal cancer, and highlight current preventive strategies.

Primary care professionals are amongst the most frequent users of the National Poisons Information Service in the United Kingdom. This paper provides an up-to-date review on the management of acute poisoning in this setting.